Baek Olivia Dybro, Hjermitslev Camilla K, Dyreborg Line, Baunwall Simon M D, Høyer Katrine L, Rågård Nina, Hammeken Lianna H, Povlsen Johan V, Ehlers Lars H, Hvas Christian Lodberg
Department of Clinical Medicine, Danish Centre for Healthcare Improvements, Aalborg University, Aalborg, Denmark.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Infect Dis Ther. 2023 May;12(5):1429-1436. doi: 10.1007/s40121-023-00797-y. Epub 2023 Apr 16.
The use of faecal microbiota transplantation (FMT) to eradicate intestinal carriage of multidrug-resistant organisms (MDRO) has been described in case reports and small case series. Although few in numbers, these patients suffer from recurrent infections that may exacerbate both the patients' comorbidities and their healths. In the current study, we hypothesized that FMT for MDRO-related urinary tract infections (UTIs) reduces hospitalisations and associated costs.
In a cohort of patients referred for FMT from 2015 to 2020, we selected all patients who had consecutively been referred for eradication of MRDO carriage with UTIs. An early economic assessment was performed to calculate hospital-related costs. The overall study cohort was registered at ClinicalTrials, study identifier NCT03712722.
We consecutively included five patients with UTIs caused by MDROs. Four of the patients were renal transplant recipients. Patients were followed for median 126 days (range 60-320), where the follow-up duration for each patient was aligned with the number of days from the first UTI to FMT. The median number of UTIs per patient dropped from 4 to 0. Investigating hospital costs, hospital admission days dropped by 87% and monthly hospital costs by 79%.
FMT was effective in reducing the occurrence of UTIs and mediated a marked reduction in hospital costs. We suggest that this strategy is cost-effective.
ClinicalTrials, study identifier NCT03712722.
粪便微生物群移植（FMT）用于根除多重耐药菌（MDRO）肠道定植的情况已在病例报告和小型病例系列中有所描述。尽管此类患者数量不多，但他们患有反复感染，这可能会加重患者的合并症及健康问题。在本研究中，我们假设FMT治疗与MDRO相关的尿路感染（UTI）可减少住院次数及相关费用。
在2015年至2020年转诊接受FMT的患者队列中，我们选择了所有因UTI而连续转诊以根除MRDO定植的患者。进行了早期经济评估以计算与医院相关的费用。整个研究队列已在ClinicalTrials注册，研究标识符为NCT03712722。
我们连续纳入了5例由MDRO引起UTI的患者。其中4例患者为肾移植受者。患者的中位随访时间为126天（范围60 - 320天），每位患者的随访时长与从首次UTI到FMT的天数一致。每位患者UTI的中位次数从4次降至0次。在调查医院费用方面，住院天数下降了87%，每月医院费用下降了79%。
FMT在减少UTI发生方面有效，并显著降低了医院费用。我们认为该策略具有成本效益。
ClinicalTrials，研究标识符NCT03712722。
